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The study team is recruiting 20 adults with spasticity due to chronic stroke and 20 adults with no neurological injuries for a 2 day study. In people with chronic stroke, one of the most common and disabling problems is spasticity (increased muscle tone or muscle stiffness). The purpose of this research study is to examine effects of dry needling on the nervous system (pathways between the muscle, spinal cord, and brain) in people with spasticity due to chronic stroke. Dry needling is a procedure in which a thin, stainless steel needle is inserted into your skin to produce a muscle twitch response. It is intended to release a knot in your muscle and relieve pain.
The total study duration is 2 days. The first visit will take about 3 hours, during which dry needling will take place, and the second visit will take about 1 hour. During both visits you will be asked to participate in examinations of reflexes (muscle responses to non-invasive nerve stimulation) and arm/leg function.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Individuals with spasticity resulting from stroke | Experimental | This is an experimental intervention in which individuals will receive dry needling to relieve spasticity in the target muscle. The study team will examine the effects of this treatment on the nervous system by performing assessments just prior to, immediately after, 90 minutes after, and 72 hours after dry needling. These assessments will examine how you move your arm or leg and how your nervous system responds to non-invasive nerve stimulation. |
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| Individuals with no known neurological injury | Experimental | This is an experimental intervention in which individuals will receive dry needling of an arm or leg muscle. The study team will examine the effects of this treatment on the nervous system by performing assessments just prior to, immediately after, 90 minutes after, and 72 hours after dry needling. These assessments will examine how you move your arm or leg and how your nervous system responds to non-invasive nerve stimulation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dry Needling | Behavioral | Dry needling is a procedure in which a thin, stainless steel needle is inserted into the skin to produce a muscle twitch response. It is intended to release a knot in a muscle and relieve pain. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in the H-reflex amplitude in response to nerve stimulation | H-reflex amplitude (mV) reflects the excitability of its reflex pathway. Changes in the H-reflex amplitude indicate that DDN influences the spinal reflex excitability. In the lower extremity this will be measured in the tibialis anterior and the triceps surae. In the upper extremity this will be measured in flexor carpi ulnaris and flexor carpi radialis. | baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN |
| 2. Changes in cutaneous reflexes elicited by non-noxious stimulation of cutaneous or mix nerves | Changes in the cutaneous reflex amplitudes would indicate that DDN can influence the spinal processing of cutaneous information. | baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN |
| 3. Changes in perception of cutaneous stimuli as measured by perception and radiating threshold of cutaneous nerve stimulation | Changes in thresholds of cutaneous nerve stimulation would imply that DDN can affect the perception of cutaneous input. | baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN |
| Measure | Description | Time Frame |
|---|---|---|
| Change in ability to move the arm or leg as measured by the Fugl-Meyer Assessment (FMA) | An increase in the FMA score indicates better movement of the arm or leg. | baseline, 90 minutes after DDN, and 72 hours after DDN |
| Change in spasticity as measured by the Modified Ashworth Scale (mAS) |
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Inclusion Criteria:
For adults with no known neurological conditions:
For individuals after stroke:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Aiko K Thompson, PhD | Medical University of South Carolina | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical University of South Carolina | Charleston | South Carolina | 29405 | United States |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| D009128 | Muscle Spasticity |
| D009461 | Neurologic Manifestations |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D000079245 | Dry Needling |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
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The mAS score ranges from 0: normal muscle tone to 4: rigid in flexion or extension. A decrease in mAS indicates decreased spasticity. |
| baseline, 90 minutes after DDN, and 72 hours after DDN |
| Change in the ability to move the limb as measured by range of motion (ROM) | ROM is measured in degrees using a standard goniometer. Increased ROM, which will be measured both passively (moved by the assessor) and actively (participant moves the arm themselves), indicates improved ability to move the limb. | baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN |
| Change in pain level as measured by the visual analog scale (VAS) for pain | Pain is rated by the participant on a scale from 0 (no pain) to 10 (worst pain imaginable). Decreased score on the VAS for pain indicates decreased pain. | baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D009122 | Muscle Hypertonia |
| D020879 | Neuromuscular Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |